Abstract：
BACKGROUND: The impact of the timing of the last seizure (TTLS) prior to admission to the epilepsy monitoring unit (EMU) on epilepsy classification is unclear for which we conducted this study.
METHODS: We reviewed patients with epilepsy admitted to EMU between January 2021 and April 2022 and identified TTLS before EMU admission. We considered EMU yield as whether; it confirmed epilepsy classification, added new knowledge to the classification, or failed to classify epilepsy.
RESULTS: We studied 156 patients. There were 72 (46%) men, with a mean age of 30. TTLS was divided according to a one- or three-month cutoff. We confirmed the pre-EMU epilepsy classification in 52 (33%) patients, learned new findings on epilepsy classification in 80 (51%) patients, and failed to classify epilepsy in 24 (15%) patients. Patients with \"confirmed epilepsy classifications\" reported seizures sooner to EMU admission than other groups (0.7 vs. 2.3 months, p-value = 0.02, 95% CI; -1.8, -1.3). Also, the odds of confirming epilepsy classification were more than two times in patients with TTLS within a month compared to those with TTLS of more than a month (OR = 2.4, p-value = 0.04, 95% CI; 1.1, 5.9). The odds were also higher when the 3-month TTLS cutoff was considered (OR = 6.2, p-value = 0.002, 95% CI; 1.6, 40.2). Confirming epilepsy classification was also associated with earlier seizures recorded at one- or three-month cutoff (OR = 2.1 and OR = 2.3, respectively, p-value = 0.05). We did not observe similar findings when we modified the classification or failed to reach a classification.
CONCLUSIONS: The timing of the last seizure before EMU admission appeared to influence the yield of EMU and enhanced the confirmation of epilepsy classifications. Such findings can improve the utilization of EMU in the presurgical evaluation of patients with epilepsy.
METHODS: We reviewed patients with epilepsy admitted to EMU between January 2021 and April 2022 and identified TTLS before EMU admission. We considered EMU yield as whether; it confirmed epilepsy classification, added new knowledge to the classification, or failed to classify epilepsy.
RESULTS: We studied 156 patients. There were 72 (46%) men, with a mean age of 30. TTLS was divided according to a one- or three-month cutoff. We confirmed the pre-EMU epilepsy classification in 52 (33%) patients, learned new findings on epilepsy classification in 80 (51%) patients, and failed to classify epilepsy in 24 (15%) patients. Patients with \"confirmed epilepsy classifications\" reported seizures sooner to EMU admission than other groups (0.7 vs. 2.3 months, p-value = 0.02, 95% CI; -1.8, -1.3). Also, the odds of confirming epilepsy classification were more than two times in patients with TTLS within a month compared to those with TTLS of more than a month (OR = 2.4, p-value = 0.04, 95% CI; 1.1, 5.9). The odds were also higher when the 3-month TTLS cutoff was considered (OR = 6.2, p-value = 0.002, 95% CI; 1.6, 40.2). Confirming epilepsy classification was also associated with earlier seizures recorded at one- or three-month cutoff (OR = 2.1 and OR = 2.3, respectively, p-value = 0.05). We did not observe similar findings when we modified the classification or failed to reach a classification.
CONCLUSIONS: The timing of the last seizure before EMU admission appeared to influence the yield of EMU and enhanced the confirmation of epilepsy classifications. Such findings can improve the utilization of EMU in the presurgical evaluation of patients with epilepsy.
摘要：
背景：在进入癫痫监测单元（EMU）之前的最后一次癫痫发作（TTLS）的时间对癫痫分类的影响尚不清楚，我们对此进行了这项研究。
方法：我们回顾了2021年1月至2022年4月期间接受EMU治疗的癫痫患者，并在EMU入院前确定了TTLS。我们认为EMU产量是否；它证实了癫痫的分类，为分类增加了新的知识，或未能对癫痫进行分类。
结果：我们研究了156例患者。有72名（46%）男性，平均年龄30岁.TTLS根据一个或三个月的截止时间进行划分。我们证实了52例（33%）患者的EMU前癫痫分类，了解到80例（51%）患者癫痫分类的新发现，对24例(15%)患者的癫痫进行分类失败。与其他组相比，“确认癫痫分类”的患者在EMU入院时报告癫痫发作更早（0.7vs.2.3个月,p值=0.02，95%CI；-1.8，-1.3）。此外，与TTLS超过1个月的患者相比,TTLS患者在1个月内确认癫痫分类的几率超过2倍(OR=2.4,p值=0.04,95%CI;1.1,5.9).当考虑3个月的TTLS截止时，几率也更高(OR=6.2，p值=0.002，95%CI;1.6，40.2)。确认癫痫分类也与在1个月或3个月截止时记录的早期癫痫发作相关（分别为OR=2.1和OR=2.3，p值=0.05)。当我们修改分类或未能达到分类时，我们没有观察到类似的发现。
结论：EMU入院前最后一次发作的时间似乎会影响EMU的产量并增强癫痫分类的确认。这些发现可以提高EMU在癫痫患者的术前评估中的利用率。
方法：我们回顾了2021年1月至2022年4月期间接受EMU治疗的癫痫患者，并在EMU入院前确定了TTLS。我们认为EMU产量是否；它证实了癫痫的分类，为分类增加了新的知识，或未能对癫痫进行分类。
结果：我们研究了156例患者。有72名（46%）男性，平均年龄30岁.TTLS根据一个或三个月的截止时间进行划分。我们证实了52例（33%）患者的EMU前癫痫分类，了解到80例（51%）患者癫痫分类的新发现，对24例(15%)患者的癫痫进行分类失败。与其他组相比，“确认癫痫分类”的患者在EMU入院时报告癫痫发作更早（0.7vs.2.3个月,p值=0.02，95%CI；-1.8，-1.3）。此外，与TTLS超过1个月的患者相比,TTLS患者在1个月内确认癫痫分类的几率超过2倍(OR=2.4,p值=0.04,95%CI;1.1,5.9).当考虑3个月的TTLS截止时，几率也更高(OR=6.2，p值=0.002，95%CI;1.6，40.2)。确认癫痫分类也与在1个月或3个月截止时记录的早期癫痫发作相关（分别为OR=2.1和OR=2.3，p值=0.05)。当我们修改分类或未能达到分类时，我们没有观察到类似的发现。
结论：EMU入院前最后一次发作的时间似乎会影响EMU的产量并增强癫痫分类的确认。这些发现可以提高EMU在癫痫患者的术前评估中的利用率。
